RESEARCH TEAM Susan Goodwin Gerberich, Ph.D. Nancy M. Nachreiner, Ph.D. Andrew D. Ryan, M.S. Timothy R. Church, Ph.D. Patricia M. McGovern, Ph.D. Mindy S. Geisser, M.S. Steven J. Mongin, M.S. Gavin D. Watt, B.A. Denise Feda, M.S., Ph.D. Candidate Evette Pinder, M.P.H., Ph.D. Candidate Starr Kelley Sage, M.P.H., Ph.D. Student __________________________________________ Center for Violence Prevention and Control and Regional Injury Prevention Research Center Division of Environmental Health Sciences, School of Public Health University of Minnesota Minneapolis, Minnesota USA Violence in the Schools: Teachers at Risk

ABSTRACT While school violence has been identified as a problem among students, little is known about violence against teachers. A two-phase study was implemented to determine the magnitude and consequences of physical assault (PA) and non-physical violence (NPV) and risk factors for PA in randomly selected state-licensed, working kindergarten-grade 12 educators (n = 6,469). Phase 1 (mailed 12-month retrospective survey) collected information about demographics, personal characteristics, and violent occurrences and consequences; Phase 2 (mailed case-control survey) collected exposure data regarding: activities; others in the environment; school infrastructure and administration; and community socioeconomic status. Cases (n=372) reporting at least one PA were questioned about exposures in the month before and during the incident; controls (n=1,116), were questioned about exposures on a randomly selected working month from all months during the study period. Potentially confounding variables were selected for multiple logistic regression from directed acyclic graphs; re-weighting adjusted for non-response in the presence of unknown eligibility. From initial results (78% response), rates per 100 persons per year were: PA, 7.9; NPV, Rates for the subcategories of NPV included: threat, 20.3; verbal abuse, 33.4; sexual harassment, 4.5; bullying, Perpetrators were primarily: students, colleagues, and parents. Consequences included treatment: PA, 22%, NPV, 16%-27%; restricted activity: PA, 4%, NPV, 4%-8%; and change in work status: PA, 8%, NPV, 13%-25%. Among the NPV events, the highest percentages were for bullying. This unique study provides new knowledge that identifies the magnitude and consequences of violence experienced by teachers; identifying associated risk factors is integral to intervention development.

MINNESOTA EDUCATORS’ STUDY CONCEPTUAL MODEL FOR WORK-RELATED VIOLENCE PHYSICAL ASSAULT TEACHERS Personal Characteristics: Demographics (gender; Demographics (gender; age; race; marital status; socioeconomic status) age; race; marital status; socioeconomic status) Body Mass Body Mass Stress Stress Education, including Education, including specialty training specialty training Illness/injury history, Illness/injury history, including assaults including assaults Violence Violence management/conflict management/conflict resolution training resolution training Work-related Characteristics Work experience Work experience Job type Job type Workload; hours Workload; hours worked/week worked/week Student contact/week Student contact/week (hours; numbers) (hours; numbers)OTHERS Co-workers: Demographics (age; Demographics (age; gender; race) gender; race) Number/types of staff Number/types of staff Interaction/support Interaction/supportStudents Demographics (age; Demographics (age; gender; race) gender; race) Number/types Number/types Mental Mental status/impairment status/impairment History of assaultive History of assaultive behavior behavior Other relevant Other relevant behaviors/activities behaviors/activitiesENVIRONMENT Facility: Type/Level/Size of School Type/Level/Size of School Area socioeconomic Area socioeconomic status status Location Location Physical design/attributes Physical design/attributes (openness; visibility; (openness; visibility; crowding; lighting; crowding; lighting; barriers; room barriers; room configurations) configurations) Security (systems; Security (systems; personnel; access personnel; access controls; parking; controls; parking; responsiveness) responsiveness)Administration/Management Administration attitude Administration attitude Tolerance of violence Tolerance of violence Support for employees Support for employees Employee Employee assistance/resources assistance/resources Support/resources for Support/resources for students students Policies/protocols Policies/protocols

Potential for: Strategies to Control: Recall bias Recall bias - 12-month recall: violent events - 1-month recall: exposures - Validation substudies Response bias Response bias Adjustment: nonresponse; probability of eligibility (Mongin, 2001; Horvitz and Thompson, 1952 Misclassification Misclassification Rigorous development and testing of data collection instruments; validation and reliability substudies; sensitivity analyses (Rothman and Greenland, 1999) Confounding Confounding Use of Directed Acyclic Graphs to select confounders (Greenland et al., 1999) MINNESOTA EDUCATORS’ STUDY LIMITATIONS

MINNESOTA EDUCATORS’ STUDY ACKNOWLEDGMENTS Support for this effort is provided, in part, by the: National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Department of Health and Human Services (R01 OH007816); Center for Violence Prevention and Control, University of Minnesota; Regional Injury Prevention Research Center, University of Minnesota; and Zayas Graphics. The authors also wish to acknowledge the support of our Advisory Consulting Team members: Willarene Beasley; Charles Goodwin; Donald Hilts; Laura R. Langhoff; and Joseph P. Miller.

REFERENCES Church TR, Yeazel MW, Jones RM, et al. A randomized trial of direct mailing of fecal occult blood tests to increase colorectal cancer screening. Journal of National Cancer Institute. 2004; 96: Horvitz DG, Thompson DJ. A generalization of sampling without replacement from a finite universe. American Statistical Association Journal. 1952; 47: Gerberich SG, Church, TR, McGovern PM, et al. An epidemiological study of the magnitude and consequences of work-related violence: The Minnesota nurses’ study, Occupational and Environmental Medicine. 2004; 61: Greenland S, Pearl J, Robins J. Causal diagrams for epidemiologic research. Epidemiology. 1999; 10: Horvitz DG, Thompson DJ. A generalization of sampling without replacement from a finite universe. American Statistical Association Journal. 1952; 47: Maldonado G, Greenland S. Estimating causal effects, International Journal of Epidemiology. 2002; 31: Hernan MA, Hernandez-Diaz S, Werler MM, Mitchell AA. Causal knowledge as a prerequisite for confounding evaluation: An application to birth defects epidemiology, American Journal of Epidemiology. 2002; 155: Mongin SJ. Adjustment for nonresponse in the Minnesota Nurses Study. Division of Environmental and Occupational Health, University of Minnesota, 2001.Available at:

WEBSITES Division of Environmental Health Sciences: Regional Injury Prevention Research Center: Center for Violence Prevention and Control: Occupational Injury Prevention Research Training Program: Susan Goodwin Gerberich, PhD